CAMHS Workbook

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The Essential CapabilitiesFor Effective Emotional and Mental Health Support

Values based materials for personal development that describe the core attitudes and behaviours

in care and support for children and young people

PERSONAL HANDBOOK

National Workforce Programme

National CAMHS Support Service


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Contents

Foreword

Introduction 1

Part 1

Setting the Scene 21.Communicate Together 5

2.Respect Our Differences 8

3.Do the Right Thing 10

4.Be Responsive 12

5.Be Hopeful 14

6.Listen and Hear Me 17

7.Give the Care and Support I Need 19

8.Dont Give Up 21

9.Keep Me Safe; Help Me Grow 23

10.Learn What Matters to Me 25

Part 2Putting Values into Practice 27

Values in the Context of Policy and Practice 29

Reviewing the Essential Capabilities 31

References 33

Appendices

A Brief History of the Ten Essential Shared Capabilities 34

Extract on left handedness 35

Example of a Mandala 36

Individual Audit of the EC for effective Emotional and Mental Health Support 37

Contributors

Exercises

1. Communicate Together 52. Respect Our Differences 93. Do the Right Thing 104. Be Responsive 125. Be Hopeful 156. Listen and Hear Me 177. Give the Care and Support I Need 198. Dont Give Up 219. Keep Me Safe; Help Me Grow 2410. Learn What Matters to Me 2511. Identify a piece of policy which directly relates to your work 2912. Statements from key policy, guidance and legislation 3013. The ideal worker 32


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Foreword

There is an entire universe of values, but some of them are so elemental, so important to us, that throughout the

changes in society, government, politics, and technology they are stillthe core values we will abide by. Societal changes

in the public expectation of health, social care and education would indicate that the ground is shifting and we need

collectively to expose our foundations to some examination in order to reassure ourselves and others that the structuralvalidity of our practice is intact.

The Essential Capabilities originate from a body of work begun in adult mental health services, extending that work to

provide a framework of core values and associated behaviours which form the foundation of high quality services for

children and young people. Led by Ian McGonagle of the University of Lincoln, and developed through a process of

consultation with children and young people, carers, managers, academics and practitioners this work adopted a

predominately outward focus and is explicitly and deliberately centred upon the needs of children and young people

and carers.

An initial and cursory reading of the Essential Capabilities for Effective Emotional and Mental Health Support could be

deceptive: there appears little to be debated or contested in these requirements for good quality care. Our national

work in promoting the Essential Capabilities however has provided a unique insight to the complexity contained withina set of seemingly simple statements for care delivery. We believe this work provides an invaluable resource to help the

workforce describe and reflect meaningfully on their work, in all its intricacy.

It is our intention that the Essential Capabilities framework will provide a positive challenge to all those working with

children and young people, to encourage all regularly and routinely to examine the foundations of practice and ensure

this practice is well supported and maintained. In addition it may be used as a resource with which to review the

flexibility of practice and challenge long held assumptions about the way care is organised and delivered. This challenge

will include the active movement beyond any rhetoric of participation towards a greater emphasis on improving the

felt and actual experience of children and young people and those who care for them.

The Essential Capabilities are important because, self evidently, for children and young people they are essential

components of a close, collaborative relationship built on trust, respect and ethical practice. They are based onthe theory and practice of effective decision-making where legitimately different and sometimes conflicting values are

in play.

In simple terms the Essential Capabilities can be viewed as a set of values with associated behaviours that all those

working with children and young people hold and display in all interactions. Ultimately, its wider benefits may be

revealed as a shared endeavour, giving voice to commonly held principles and ideals that will prevail over differences

in ideology, procedures or protocol, real or imagined.

Barry Nixon

National Workforce Lead - CAMHS


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Introduction

Background

These ideal standards for people working with children and young people originate from a body of work

begun in adult mental health services in 2004 called the Ten Essential Shared Capabilities (ESC). These

original materials were developed, by people who used services, as a set of statements on the idealpersonal attributes they would like to see in the workforce.

In 2009 the National CAMHS Support Service (NCSS) National Workforce Programme conducted a piece of

work to further develop ESC for working with children and young people. Of course the original ESC were

applicable equally to working with young people, but the way in which they were framed and the language

used did not necessarily speak to a younger audience.

Following extensive involvement with children and young people, a new values framework has been

created, retaining the core principles and elements of ESC (see Appendix 1 for the original 10 ESC).

About this handbookThis handbook encourages you as a practitioner to reflect on your approach to working with young people

and in the spirit of continuous improvement, seek better ways to perform your role.

Values based work, such as this, needs open discussion and honesty and while it is written in a manner

which supports individual reflection, it is essential that you use all the exercises in the handbook to discuss

your ideas with colleagues. Difference of values is a reflection of the world we live in, we do not all believe

the same thing, we do not all value the same things. It is through communication and negotiation that we

understand our unique value positions and that we appreciate and understand those of others.

These ideal standards or essential capabilities are based on the theory and practice of effective healthcare

decision-making where legitimately different (and sometimes conflicting) values are in play. The principal

underlying assumption is that there is respect for difference and diversity (Woodbridge and Fulford, 2004).

Who the handbook is designed for

This handbook is designed for all individuals and teams working to promote the emotional well being of

children and young people, in a wide range of settings. It aims to help you and your team discuss the sort of

treatment, support and care, you would like to provide and the kind of support you would like to receive

from your organisation and the other agencies you work with.

How to use the handbook

In Part 1 each Essential Capability is presented as a separate section. The materials are organised so that

each section contains suggested learning outcomes, brief explanatory text and extensive input from

children and young people, followed by a reflective activity for practitioners to complete individually as well

as in discussion with colleagues and team members. Every section ends with a creative activity that can be

used either with practitioners and/or with children and young people, to explore the key concepts using

art.

Part 2 explores the role of policy and evidence in values based practice.

It is suggested you work through the sections in order, but it is also possible to use the materials by

selecting the sections in any order you feel is appropriate.

Follow these standards so that you can offer help that will really make a difference in our lives


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Setting the scene

What are the Essential Capabilities for everyone working with children and young

people?

The perfect worker

The perfect worker spends time with you, wants to do stuff with you, wants to listen to your problems and

answer them sometimes. Im not saying they can answer everything because obviously they cant, but

somehow they make you feel better. They make you feel like they want to know you; that they actually care

for you. Ive actually met staff that is just there for the money and they have even said it. The staff that I

like, you know that they actually care because they listen to you, and they show you that they want to help

you. They do this by spending time with you, having a coffee and a chat, even if you are having a bad day,

you wont take youranger out on them. Some workers in the childrens home. it is not the right job for

them because theyre not going to do anything; they will never be a good member of staff. But the ones that

are professional, the ones that do actually care and look after the house and the kids are the ones that

teach you and spend time with you.

At the end of the handbook you can assess how close you are to the perfect worker.

The Essential Capabilities programme is an approach to re-attuning ourselves to understanding what the

fundamentals of a good service are (from a child/young persons perspective) and to re-appraise our

application of these behaviours

The Essential Capabilities (EC)

The following is a set of consistently expressed statements made by young people when discussing the

ideal standards of attitude and behaviour or people who work in services:

1. Communicate together:

Communicate with me in a way that I understand and am comfortable with

2. Respect our Differences:

Be respectful of who I am and treat me as an individual, because no two of us are the same

3. Do the right thing:

Do what you say you are going to do

4. Be responsive:

Be flexible and adaptable to my needs5. Be hopeful:

Giving clear, accurate support and information to help me make the best choices I can

6. Listen and hear me:

Give me the chance to make my own decisions and have my voice heard

7. Give the care and support I need:

Give me the help I need to helpme get on with my life.

8. Dont give up:

Always look for a positive solution and dont give up if things get difficult.

9. Keep me safe, helping me grow:

Believe in my participation in my life.

10. Learn what matters to me:

Take time to learn about howthings appear to me


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A historical perspective

When reviewing the list above with its short descriptions, you may think that these are values and

behaviours that to which you already subscribe. At this level of analysis, the issues of values based practice

can seem superficial and elementary at first glance. However, a deeper investigation will prove illuminating

for your practice and the practice of your team. It is some of the simple things that really matter!

Much of our professional education and development is based on specialist knowledge and its application

to technical skill. Naturally we need technical skills drawn from the best scientific evidence in order to

provide high quality care, education and support. The essential capabilities for children and young people

are designed to ensure that those technical skills are based on solid foundations.

The idea of inextricable links between knowledge, skills and values is not new; Aristotle working in the

fourth century described:

Epistome:the knowledge required to understand and complete ones practice;

Techne:the technical ability, craftsmanship, or skill necessary to complete a job; and

Phronesis: a kind of practical wisdom, the application of fine judgement in managing problems or setting

out the requirements of the work.

These materials propose that attending to the values base which supports our work is an example of

practical wisdom. Without an appreciation of, and attention to values (phronesis), we tend to become

merely knowledgeable and technical workers and our appreciation of the human can be lost.

Overall learning outcomes

At the end of this programme of study you will have

Gained an understanding of the Essential Capabilities for children and young people Enhanced your understanding of the role that personal and professional values have in your practice Enhanced your understanding of the dynamic nature of values based practice in supporting high

quality service provision.

The above will be achieved through:

Development of a shared approach to supporting learning in colleagues

Integration of policy and values in setting the context to practice Analysing personal and professional values as a tool to understanding practice and decision making.In order to focus on the human aspects of support, care and treatment, these materials were developed

following full and active consultation with groups of children and young people. Consistently, these young

people requested services and behaviour from workers which reflect the values discussed in this document.

While a range of opinion and views was expressed and some young people felt services were generally ok,

all those consulted and involved thought that improvements should be made.

Staff spend their time looking down at me

Its as if they are saying Im big, youre small

They ask my opinion, but I dont feel comfortable saying that things are not right, so I just leave it

They look at me as though I am a Chav


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How would you feel if these statements were made about you?

You may be thinking it goes without saying that children and young people are of paramount importance in

the service.

Yet many young people felt unimportant.

We all may like to believe it is important that young people express their feelings about services.

Yet many young people felt unable or uncomfortable about doing so.

It is a given that unconditional positive regard and empathy are central to work with this client group.

Yet many young people felt judged and excluded.

Even if these are rare instances in otherwise excellent services, they still require our attention. Reflection

and evaluation on services and on good practice is a hallmark of provision of high quality care. These

materials provide an opportunity to examine the values which underpin that practice and those services.

Stop and reflect

The intention of the previous section is to set the scene and provide a rationale for exploring values and

practice. You can use the following space to write your immediate thoughts and reflections about whether

and how these materials may prove to be helpful in your own practice.


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1. Communicate together


Learning outcomes

At the end of this section you should be able to

Identify the barriers and potentials in including children and young people in their own care Discus ways that practitioners can help each other to help children and families Describe a collective effort to reach goalsWhat young people say

In our experience workers rarely ask us if things are okay with us, they always ask the parent and look past

us! Young people should be allowed to make decisions too even if the parent is in the session. It is wrong for

workers to just include the parents and what their wishes are, after all we are all there because of our

(young people's) needs.

By including us equally we are made to feel valued and are more willing to participate positively in thesession and the whole of the service. There are many choices that we can share in the decision making

about, such as:

Whether we want to be seen by ourselves or with our family. What worker we have The location that we are seen What the sessions will be about What is the best way to communicate with us and build up a relationship Shared decisions about medication How best to end the service with usWith real user participation we can help the service:

Run young people interview panels and employ new staff Improve how the service promotes itself Improve how young people experience services Improve the environment of the service e.g. waiting areas.Remember to respect us and include us. Our involvement is invaluable to our recovery and to the

improvement of the services we use. If we are not given a choice we then feel like we are being told what to

do, that we are being treated like a child and it's scary as we are not in control of anything in our lives. It is

important to let us share in the decisions that we can make when it is safe for us to do so.

Exercise 1

Read the scenario, then complete the reflective exercise.

Communicating together through multi-agency working: from a head teacher perspective

Proactive links with other agencies are crucial to meeting the needs of pupils in line with the outcomes of

Every Child Matters. However the process of interagency working is often very frustrating, complex and

time consuming.


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This is demonstrated in the case of a young pupil (aged 8), who started attending my school. The pupil,

mother and two older siblings aged 11 and 12 were relocated from another part of the country as the childs

motherhad been a victim of domestic violence. Mums partner was a drug dealer. The child had witnessed

violence against the mother, who was left with life threatening injuries. The police service was involved due

to the witness protection scheme.

The childs two older siblings started attending a local secondary school. Understandably the child exhibited

very challenging behaviour, did not want to leave mother and did not want to attend school.

My school quickly put into place support for the pupil via referral to Challenging Pupil Project and arranged

in-school counselling sessions with an NSPCC trained counsellor plus an individualised behaviour

programmer.

Mother gave her consent for me to make a referral to the school health service to see a paediatrician and

took up the opportunities signposted to her by her key worker and myself, agreeing to attend a freedom

from domestic abuse programme and a course on managing childrens behaviour. The paediatrician

assessed that the child would not meet the criteria for specialist CAMHS and this was supported byone of

the Primary Mental Health Workers (PMHW), who recommended the child should be involved in the next

nurture group programme, which was led by a specially trained teacher and a teaching assistant, with

consultation and supervision from the PMHW.

It also became evident that the education welfare officer (EWO) would only become involved if the childs

attendance fell below 80% in a term or if the child is frequently late arriving to school.

As head teacher, I asked the mother if she would co-operate in completing a Common Assessment

Framework (CAF) to access additional support for the family as a whole. She informed me emphatically that

she did not want any involvement from social care (Mother had very negative personal experiences of social

care as a young person herself).

The PMHW arranged that the leader of the parenting programme (which the mother had attended well)

would speak to the mother about the CAF. Mother had not realised that one of the parenting programme

leaders was from social care and the staff used this as an example of how social care had changed from

since the mothers early experience. As a result, mother agreed to a CAF.

One of the childs older siblings had been involved in a behaviour incident within 2 weeks of starting at

secondary school. The other sibling was waiting for his admission form to be processed to attend the same

secondary school and had not attended school for several weeks as had received several fixed term

exclusions at his previous secondary school which had attended for one and a half terms.

The response from each agency, which is appropriate, will be to recommend that the school completes a

Common Assessment Framework CAF as school staff have direct and daily contact with the child/parent.

The CAF is designed to draw together all the agencies involved with the child and his/her family, however,

whoever completes the form becomes the lead professional and responsible for co-ordinating, liaising and

organising meetings which creates a huge volume of work.

The local CAF pathway allows agencies to agree who will complete the form, depending on earlier contact.

It was agreed through telephone calls to the different staff supporting the family that the PMHW would

complete the form and become the lead professional as she was to some extent already responsible for co-

ordinating, liaising and organising meetings. The family support worker, already involved with mother

through the parenting programme, could also have completed the form. Both post holders had time builtinto their work programmes for CAF work.


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It really has been worth the time and effort to develop our local pathways and protocols, because at those

times where you get a family with many difficulties needing support there is no question of who will take on

the work and how it should be done. We can all get on with what we are supposed to be doing and we feel

were getting better outcomes for our families locally and as a result the morale of staff across the different

services is better. There is still too much work and it is still very challenging, but everyone knows that we are

working together and making a difference.

Reflect on this scenario and consider

a) Whose needs are being met?b) Would an emphasis on the views and experience of the child concerned alter the outcomes?

Write your thoughts here and discuss with a colleague.

A creative way to communicate together


Model: 2 into 1

You will need: Plasticine or clay

Take some modelling dough/plasticine and make something. Get together with another person and create

one model using the two separate models.

Talk about what happened when two became one.


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2. Respect Our Differences


Learning outcomes


Say what is involved in accepting yourself and others Demonstrate respect for difference Describe how it is to be understanding and open minded.Self evidently children and young people consider themselves to be important people. This means treating

children and young people and their family/carers with respect and responding to their uniqueness.

This capability on respecting difference promotes the view that children and young people have their own

cultural identity, may speak in a preferred language and seek to respond to their own customs. In many

ways children and young people are the same as each other and in many ways they are uniquely different.

It is important that people who work with families have training and that their practice reinforces their

understanding and value of uniqueness and difference.

The way practitioners believe children and young people develop and the support they think children and

young people should receive from the family is not a value free assessment. Practitioners should be alive

to the cultural, racial and religious backgrounds of young people and understand alternative value

frameworks and assumptions.

What young people say

We all have different ways of talking, communicating and understanding because of our age, ourbackground, our education and possibly a physical or learning disability. It is important that you work with

us as individuals and take time to understand how we take in information, understand it and give it out. To

do this you will have to take time to build up a relationship and ask us directly how we want information to

be given. It is very important to always check with us whether we understand what you are telling us and to

make us feel comfortable and confident so that we can ask you questions and tell you when we are

confused.

Make sure that you pay attention to how appropriate and correct the information you are giving is, how it is

being communicated e.g. verbally, through body language, written word (letter, leaflets, website, email)

and how it will be interpreted so that there are no misunderstandings. Do not use jargon with us or long

medical words (unless we say that this is how we want the information given). Always communicate

respectfully with us making sure that you are honest, that you answer all our questions, that you do not to

raise your voice in anger, lose your patience or swear at us (in fun or frustration). Treat us like young adults

and be honest with us.

For younger or disabled young people there should be pictures to explain what the text means, big writing,

clear and colourful and be given at the pace that we are comfortable with.

It is important that you see that we are all different from each other. We all have different levels of

education, different cultures and religions, different experiences and ways of dealing with our feelings.

It is important to change your style of working and communication for each of us that you work with. By

changing the way you work with us you are respecting our individual importance. If you dont adapt your

style to our needs the course of treatment that you choose to use may well not be successful.


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It is important that you do not assume that because someone is of the same race, culture or religion as you,

they will work best with you. Sometimes this does not work well for us as there is a bit of a conflict for us

because we fear that we will be judged and pressures will be put on us that we may already be experiencing

at home and in our personal life. It would be good to be asked what we would prefer and have the choice of

what type of worker we would like e.g. male, female, gay, Asian etc.

What we really need is a worker that understands where we are coming from, how our background may

affect us and what challenges we face in life. A worker does not need to be from the same culture but you

do need to show that you are interested in learning about us. You can do this by talking to other workers

from the same culture to get an insight about our community and by learning from us by asking us

questions and showing an interest in our whole life rather than just what our problems are. Be open

minded, non-judgemental and willing to learn.

Exercise 2

After doing this exercise yourself, raise the same questions with a number of colleagues (maybe the people

who work in your team). There are no right or wrong answers to these statements. Please remember thecentral tenet of values based practice: Respect for diversity and difference

Tick one box for each statement, avoiding the middle box if you

can

Strongly

agree

Maybe/

Not sure

Strongly

disagree

1. Left-handed children should be trained to use their right handfor everyday activities

2. Large multi-national clothing firms sell items cheaply, quitepossibly due to child labour being used. We should boycottsuch firms

3. If all the key people agree, children who need medication forthe maintenance and improvement of their behaviour should

be obliged to take it.

In discussing with colleagues you will be asked to justify your decision in responding to the statement.

After you have shared your views with others, you may want to re-assess and possibly alter your position.

This exercise is designed to illustrate that we as workers may hold very different values about aspects of

care and support for young people. The difference in value does not stop us working together, but rather it

is important to share and understand how we each see the world. When we understand other peoplespositions, we can work more effectively together.

You may wish to read through the extract in Appendix 2 as an illustration on the life of left handed people.

A creative way to respect differences


Draw a tree

You will need: Paper, pens, pencils and/or other painting drawing tools

Give people two minutes to draw a tree (this reduces the time when people consider all the reasons why

they cant draw)

At the end, look at all the trees and note that each will be different this exercise will illustrate our

connectedness and our uniqueness.(Idea from M. Learmonth & K. Huckvale from Insider Art)


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3. Do the right thing


Learning outcomes

At the end of this section you should be able to Outline some of the issues involved in being fair and honest Discuss what is involved in the commitment not to harm people Describe what is required to do what you say you are going to do.We should always try to do the right thing. However, when we are faced with problems it is sometimes

hard to know what the right thing is. Providing support and care for children and young people is littered

with dilemmas. When you are asked to act in someones best interests, there may be any number of

personal and professional conflicts that arise. Children and young people may want more responsibility, but

you must be assured of the capacity and capability to make use of that responsibility. All health, education

and social care staff have degrees of regulation and codes of practice and there may also be local policies

and protocols to guide action. These may be based on ethical principles but can only be used to guide

action; there is always uncertainty at the margins of practice.

Exploring the values which may underpin your decision making in these instances is a critical skill in the

support and care of children and young people.


Make sure that you explain to us what the aims of the support are, make sure that we know how things

will change, if at all. Give us honest and realistic responses but change how you tell us this information

when we are more emotionally unstable.

Make sure that you explain information to us before an event happens so that we can prepare ourselves.We have a right to be told what decisions are being made and even have a say about the decisions that will

affect our lives.

Be honest if you do not know the answer to my question do not pretend to know and end up giving me the

wrong information. This can be damaging for me and will make me not trust you. It is okay to say to me I

dont know but I will find out for you.

Exercise 3

Read the scenario then complete the reflective questions.

John is a manager in a team. Sally wants to talk to John about her colleague, Clare. Sally mentions she is

concerned there is domestic violence at home; she has noticed bruising in Clares upper arm and notes she

has been a little withdrawn recently. Both Sally and John know Clare and her partner very well, but John

does not appear to share Sallys concerns. They both know Clare and her husband row, but John is unsure it

would ever result in physical violence. John also thinks that Clare can be challenging.

John agrees to speak with Clare but does not do this.

1) Do you think John has done the right thing? (If not, what do you think he should have done?)2) What values do the two people in the above scenario appear to hold?3) Have you thought of whether there are children involved in the scenario if so how would this

change your approach?


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A creative way to explore doing the right thing


Mandala(see Appendix 3 for an example of a Mandala)

You will need: paper with an outline of a mandala pattern there are many available at:

http://www.free-mandala.com

Mandalas are symbolic of wholeness, we feel whole when we have been treated right. You can colour in

your mandala pattern using whatever materials are available, pens, paints, glitter, and sequins.
http://www.free-mandala.com/http://www.free-mandala.com/


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4. Be Responsive

Be flexible and adaptable to my needs

Learning outcomes

At the end of this section you should be able to Describe ways in which everyone can do their share of the work Discuss the challenges in helping young people with access to support Suggest ways of responding flexibly and allowing opportunity.Seeking to challenge the impact of mental health stigma, discrimination, social inequity and exclusion about

children, young people, their families and carers is fundamental to the promotion of psychological well-

being (Social Exclusion Unit 2004). Positive gains can be made if children and young people have valued

social roles and that these are maintained over time. Not only does the child or young person benefit, but

so too do their families, carers and services.

However, achieving these gains is not an easy thing to do. The issues around mental health andpsychological well-being have long been associated with stigma and unequal treatment. Young people with

a range of problems, including learning disability, have been marginalised and in some cases excluded from

appropriate inclusion in care services and other support.


My worker comes and meets me at my house or they take me out for our session to McDonalds or a coffee.

This is good because we are not stuck in a pokey room in a building with a camera stuck in my face. If it is

my own house or somewhere I know it makes me more relaxed and it is easier to get to know the worker

and talk to them.

Exercise 4

Read the scenario then complete the reflective questions.

Michael is sitting at a table with others in a group, doing school work. He looks frustrated, making sighing

noises, pushing books around and generally fidgeting. An adult (Dave) who is at the table wants to help

and says dont let it beat you Mikey, you can do the work easily, I know you can. If you want I can help,

Ive got a few minutes spare

This intervention does not appear to alter the situation significantly as Michael continues to fidget, sigh and

generally disturb others around the table. Eventually he slams the book shut and throws his pencil down

and swears.

Dave responds by saying whats the matter with you, Im only trying to give you a bit of help, dont be a

pain. Dave goes on to explain that not completing his work will mean there are negative consequences for

him. He suggests Michael leave the room in order to have time out and calm down. Michael says he is not

going out of the room, and wants to stay where he is. Dave now insists he leave and that should he fail to

do this, Dave will summon help to aid his removal.

1) What does this interaction say about responsiveness and flexibility?2) What is Michaels responsibility to others?3) What is Daves responsibility to Michael?


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A creative way to be responsive:

Be flexible and adaptable to my needs

Feelings Plate:

You will need: Paper plates, pens, pencils and/or other painting drawing tools, glue sticks and a variety of

collage material (feathers, foil etc.)

Use the paper plate to create a collage of how you feel and talk about what you would like people to do to

help you remain in this feeling or to change it.


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Magnusson and colleagues (1993) have proposed an alternative approach to problem solving when working

with young people which relies on the following:

I. Forging commitment to instil a sense ofhopeII. Providing information to support a change in attitude

III.

Practicing skill development to breed confidenceIV. Planning to achieve new goals

Exercise 5

Read the following information on the above approach then do the reflective activity.

Commitment

If young people have doubts about the outcome, why would they join in? Why would they engage in a plan

of action? Therefore how do we engage young people to really commit? Without commitment they are ill-

prepared to make best use of the help that is on offer. Commitment is about a sense of vision for the future

ask yourself how do I help provide this?

Information

Finding information can be deliberate or accidental, either way it is a mutual quest in a partnership in

education, support or care planning. Information here can be behavioural (exposure to new environments

and new things when done carefully - is a powerful learning tool). New information can challenge existing

assumptions.

Skill Development

Noting that a change may be required may mean the learning of new skills (think about becoming

independent, managing finances and cooking etc). With developing new skills comes confidence the link

between hope and confidence is the most powerful link in promoting change and aiding recovery.

Planning

You may think that planning would be one of the first steps in problem solving. Magnusson and colleagues

believe that as we gain commitment, we obtain hope; with information comes attitudinal change which

supports our development of new skills and so to our confidence. With this increased confidence we are in

a position to plan for a new start or a new way of doing things to help achieve our desired goals.

Reflect about a young person you are working with (or one you have worked with recently) who is

experiencing difficulties in making changes or responding positively to a transition in their lives.

Starting with number I in the above list and working sequentially, what actions will you need to do to help

them reach number IV?


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A creative way to be hopeful

Giving clear, accurate support and information to help me make the best choices I can

Draw a sun & group sun collage

You will need: Paper, pens, pencils and/or other painting drawing tools, a large sheet of paper with anoutline of a sun rising.

The sun rising represents a new day and new hope.

In a small group collage, everyone contributes to its illustration. (Idea from M. Learmonth & K. Huckvale

from Insider Art)


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6. Listen and Hear Me

Give me the chance to make my own decisions and have my voice heard

Learning outcomes

At the end of this section you should be able to List some of the aspects in asking good questions Describe ways of finding out what children and young people can do Consider what children and young people may need to do betterWorking together to listen to the child or young person (and to their families and carers where appropriate)

is at the heart of person centred care and treatment. Part of the core business of services for children and

young people is to develop and promote mental health and psychological well-being, to prevent mental

disorder and provide support to children and young people. It is essential that those working with children

and young people can recognise and build on strengths and resilience factors in the child or young person,

their family or carers.


By working with you we hope to build our self esteem and confidence. It is important to help me feel

positive about myself. Some of us feel negative all of the time and this causes stress for us and others

around us. When you have high self esteem you are happy all of the time, you feel confident to speak up

and learn how to keep yourself healthy. Positivity is the best feeling for us because when we are negative

we get upset and destructive towards ourselves or towards others.

You can make us feel positive by making us laugh, complimenting us, involving us, giving us a chance to talk

and listening to us.

You can also make us feel negative about ourselves by firing questions at us, not giving us time to think, by

being too critical and hard on us and by bringing your negativity to our work as this will be passed on to us.

This will makes us feel like you are picking on us, that we are not important and that you are not interested

in helping us in a real way.

Workers should give us help when we ask for it and when you can see that we need it rather than ignoring

us. Dont always make us have to ask as we might not be confident to do this, respond to our needs when

we communicate them verbally or through our actions.

Exercise 6

The audit tool (Appendix 4) can be utilised at this point. You can complete it in your own time (however

long you wish to give it) and score it yourself. The tool works best if a group of colleagues or team

members complete it, as it generates discussion about how individuals approach their own practice

compared with how teams do so (it is assumed that all people work in one form of team or another). The

practice of individuals may be either in or out of sync with colleagues on areas of practice.

It is important to reiterate that while this scale is scored it is done so only to show areas for discussion in

sharp relief. High team scores and low individual scores on the same capability may indicate an area of

fruitful discussion. All scores can be justified based on your own experience and examples from your

practice. Importantly there are no right or wrong answers and all views must be respected.

After you have completed and scored the scale on your own (ideally this is best done prior to commencing

training) either in pairs, triads or as a whole group discuss your scores and your rationale for reaching the

conclusions about your own practice and that of your team as a whole. The significant differences as well

as the commonality in your scores are the most fruitful areas of discussion.


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A creative way to promote being heard

Give me the chance to make my own decisions and havemy voice heard

Stripe picture

You will need: blank post cards and strips of coloured paper; glue sticks; paperThe stripe picture can be as simple as sticking 4 coloured strips of paper onto a piece of card. You may be

more adventurous and weave the strips or create other interesting patterns. The individual pictures can be

joined together to create a larger single picture.

This activity allows for choice to be made in designing each of the individual cards. When joined together,

it symbolises the place, value and contribution each of makes in our society or community.


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7. Give the Care and Support I Need

Give me the help I need to help me get on with my life.

Learning outcomes

At the end of this section you should be able to State how you can put the needs and/or wants of children and young people first Discuss the importance of family and those that care for children and young people Describe ways of working with othersBeing clear about the care that children and young people need and the support required by their families

and carers is the issue contained within this essential capability descriptor.

This entails making a distinction between the services on offer and the support required. This brings in

ideas around personalising services and being creative in the range of support services which can help

achieve goals. The practitioner may need to collaborate with a range of services in a variety of settings. It

will require the ability to negotiate and to promote an approach to self care and empowerment in supportand care planning and practice.


It is very important that you really think about where you are meeting us and asking us to work with you.

To get the best out of us we have to work somewhere that we feel comfortable and know. Dont just assume

that we have to meet at your service. What about getting to know us in a place that we like to visit and

where is familiar to us, get us involved in different activities, take us out, think creatively about how we can

get to know each other, communicate and build up trust.

If we have to meet in your service make sure you spend lots of time introducing us to the place and the

people that work there. We need to feel that where we meet is friendly, safe, and confidential and a place

designed for us and our needs.

The best way to find out how to work with us is to ask our opinion and include us in planning our time

together. We do know you have other people to see so be honest about what you are able to give us and

what the rules are. By agreeing a plan with us we can let you know if we prefer to just talk, do art with you,

write down what we think, go out in public with you, or try new things to build up our confidence. Helping us

is not about pressuring us with lots of questions all of the time. We do need a chance to get things off our

chest but we should also do fun things and have time to relax.

You have to be aware that our problems do not fit neatly into the time that we have in a session and we

may need to speak to you on the phone in an emergency or meet with you sooner than arranged.

Exercise 7

Reflect on how you give the help a young person needs within the context of your own practice of care,

making a distinction between wants and needs- we may want something but not necessarily need it.

How can your practice reflect the values base to this capability? In the chart below, consider the issues

related to assessment, planning, intervention and evaluation, in providing care that a young person may

feel they need.


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Assessment Planning

What Getting the help Ineed means for your practice

Evaluation Implementation


A creative way to give care and support

Give me the help I need to help me get on with my life.

Home/nest building

You will need: Paper plates, plasticine, collage material; card glue sticks.

Make a home for a small animal or toy on the paper plate using a variety of materials.

Talk with others about your creation and what it means to feel secure where you live.


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8. Dont Give Up

Always look for a positive solution and dont give up ifthings get difficult.

Learning outcomes

At the end of this section you should be able to Suggest ways of doing things better List ideas for giving young people the best possible service Show you can do things that workThe practitioner has a duty to continuously improve in their practice. This will entail approaching care for

children and young people with a view to offering the best care available and to promote and use the most

effective treatment and resources.


Be organised and punctual as this makes a good impression and makes us feel confident about you and

your skills. It is important to be on time because that shows us that you want to be there with us and are

serious about helping us get better. We need to feel that you care about our case and that you are not just

paid to be there.

It would be good if all the workers would be on time and not 10-15 mins late for their appointments with us.

If you are late for our session it is us that suffer because we do not receive a full length session from you as

you make up your time by cutting into ours. When you are not on time we are made to feel extremely

uncomfortable in the waiting room, wondering what is happening and feeling anxious that the help needed

is not being offered adequately.

You should always make sure that you are already waiting for us in the room so that we can start our

therapy as soon as we arrive. If we are left alone in the room waiting for you it causes lots of anxiety and if

you take a long time so many thoughts and worries spin around in our heads. Not being punctual and

organised can be a very negative experience for those of us that rely upon having order and structure such

as for those of us who have autism. Not knowing what is happening, feeling unimportant, uncomfortable

and let down can be a trigger that results in us 'kicking off' or clamming up and not wanting to speak openly

too you. Always show us respect and let us know if you are going to be late so we understand what is

happening and what to expect.

Exercise 8

Read the quotes below and respond to the reflective activity.Children often find it difficult to talk about feelings and emotional health. It takes considerable skill on the

part of a worker to support children to express their emotional and psychological concerns.

I feel ashamed, I cant talk about it I have a dark secret

(Child aged 10)

Im very scared there is something wrong with me. I think Im ill

(Child aged 11)


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Imagine being faced with the above statements.

How might you react? What images do statements like this conjure for you? Is it ok for children and young people to have secrets, dark or otherwise? At what point does a secret, know only to you and the child, need to be shared with other workers?Write your thoughts here and discuss with a colleague.

Reflection point

There may be elements of intense shame in admitting that all is not well, that they feel different, that they

are worried about bullying. The young person may be frightened and concerned about their ability to

control their emotions. Just think, if you were in this situation, what kind of worker would you like to be

with?

Values based practice is based on a reflection on these issues and re-iterating the need to act positively to

create synergy between values and practice. Remember Capability No.3 Do the right thing

A creative way of not giving up

Always look for a positive solution and dont give up if things get difficult.

Paint and scraper pictures

You will need: paints and plastic scrapers, paint brushes, scourers, paper and collage material.

Squeeze paint onto the papers, swirls the scraper through the paints and transform the picture. You can

use fingers and hands to add additional texture to the finished result.

Only you know when your art is finishedso dont give up until then.


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9. Keep me safe; help me grow

Believe in my participation in my life.

Learning outcomes


Discuss ways of keeping people safe Raise the issues and concerns in giving and sharing responsibility Suggest techniques for sharing ideasPart of the growing up process is achieved through making mistakes and learning from them. Therefore

having the opportunity to make mistakes, to fail in tasks, is a significant feature of development in young

people. This involves taking risks and this descriptor is about the relationship between keeping children

and young people safe and supporting appropriate risk taking that can help children and young people (and

their families and carers) learn and grow.


To be able to help us, you have to be able to see our lives from our point of view, do not assume that you

know what we have been through and how we feel. Take time to learn about us, how we think, what has

gone on in our past and what our current circumstances are. You will not find this information out unless we

feel comfortable and safe with you and we are willing to talk about our lives.

As a worker you should be an intelligent person who respects us as young people and that we can have

interesting discussions with you. We would value a worker who tries to empathise with us but you should

not pity us.

Listen properly and take in what we say and how we say it, do not just look like you are listening to us when

really you do not hear us. It is important that our experiences are heard in the way that we want to express

them and they are seen through our eyes.

It is important that we work with someone who cares and who knows where you are coming from and what

you are talking about.

It is important that we can depend upon you and believe that you are telling us the truth when you say you

are going to do something for us. If you tell us that you can keep our information confidential then we

expect this to happen and not to find out that you have talked about our lives with other people. It is wrong

if you share our private information with others without us having the choice for it to be shared or at leasttelling us beforehand that this has to happen for our own safety.

When we are working together you must stick to our plans that we agree and keep your promises. You

might have told us that you will get us some information, that we will go out or what we will talk about the

next time we meet. It is not okay to change these plans at the last minute without asking us if it is okay. We

will have spent time getting ourselves ready for our next meeting and working out all the things we want to

tell you. If you cannot do what we planned together then let us know before our next meeting rather than

waiting till you see us.


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Exercise 9

This capability refers to supporting normal development in decision making and moving towards optimum

independence and autonomy. Such an aim always presents avenues of risk assessment and management.

Read the scenarios below (the first is a newspaper clipping based on a real case).

Non voyageIn August, while aged 13, Miss Laura

Dekker was taken into child custody to pre-

vent her voyaging alone through some of

the world's most dangerous waters. She wasstopped from setting sail just days before

Mike Perham, a 17-year-old Briton, broke

the current world record for being the

youngest ever around the world solo-sailor,

a voyage she wanted to emulate.

In spite of Miss Dekker having the support

of her parents, the Dutch courts ruled in

October that she was too young to be awareof the dangers and that an isolated two year

voyage on the high seas would damage her

development.

A 13 year old girl who everyone agrees is a mature thoughtful child who never gets into trouble andwho looks older that her age, wishes to have a piercing. However her parents disagree. She asks youfor your opinion and assistance.

A 12 year old boy wishes to go out and meet his friends on a Saturday afternoon in town. He wants tocatch the bus and travel the 5 miles independently and says he will return later. He asks if this will be

acceptable to you.

An 8 year old girls mother has died suddenly. She states she wants to go to the funeral. Howevermany members of the family are concerned about her ability to deal with this difficult situation. As

you are close to the little girl they ask for your help in changing her mind.

Reflect on the issues in each case around keeping a young person safe and also helping them grow and

develop as young people.


A creative way to grow and be safe

Believe in my participation in mylife.

Poem pictures

You will need: paper, pens, paints and collage material.

Emotional development is an ability to form close relationships and the ability to express emotions. Poetry

is an art form which encourages the expression of deep emotion in a controlled form.

Try and write a verse or rhyme on the subject of safety, emotion and growth and decorate your poem with

a picture or illustration.


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10.Learn What Matters to Me

Take time to learn about how things appear to me.

Learning outcomes

At the end of this section you should be able to Demonstrate knowing more Show how to do things better Know what worksWe are always learning and this essential capability makes it clear that we have a responsibility to continue

to learn better ways in which we can perform our jobs. It involves taking part in training and using

supervision and support as a way of learning about ourselves and the care and support we provide.


Working with us effectively can be affected just by the way you look. If you look strict we are not going to

feel comfortable with you. If you are working with us consider not dressing so formally, a suit may make you

look too strict as if you are not there to work with us and we are in an interview. You need a balance of

smart/ casual as going too far the other way and dressing in lazy clothing such as sportswear and casual

jeans makes us doubt your skills and professionalism.

If you look comfortable and relaxed then we will feel more relaxed too. Sometimes a worker can make you

feel relaxed without you even realising what they are doing. Their use of friendly body language (relaxed,

facing you, sat back, soft hands, smiling) helps us be more open and encourages us to talk.

Remember what you look like is very important to how we experience the support you give us. Smile at us to

encourage us to talk it makes you seem more approachable and friendly. Do not cross your arms tight

across your chest it makes you seem unapproachable.

Remember that we will know if your body language does not match your words and this will stop us talking

to you. We will know if you are pretending to show an interest in what we say but you dont really c are or if

what we are talking about makes you uncomfortable i.e. our sexuality. We need workers that are not

judgemental and are comfortable working with us and all our issues. This cannot be faked!

Services where you work need to think about their image also. Help make your service seem approachable.

We want to walk in and not be stared at by everyone. It needs to feel like it is normal to walk in there and

then be greeted at a friendly reception who takes you straight to your worker so you can talk.

Being in the waiting room is a negative experience. Everyone looks at you thinking what are they doingthere!? you are shouting in your head I am not a freak! I am not a circus act! Waiting there makes you feel

really uncomfortable. All you want to do is go talk to your worker and get out of this uncomfortable

situation.

Exercise 10

Review the following two comments from young people and examine the capabilities you have studied.

Reflect on your individual learning and that of your colleagues in seeking positive and purposeful

interactions with young people.

In my childrens home normally there are just two members of staff on and they are always in the office.

When I need help I go and say can I talk to you for a minute? they go no, come back later. I think...you

are supposed to be here to care, not to turn me away. They are never there when I need them.


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My school did not keep the information confidential. I went to people at school for help, to tell them I am

gay. (One member of staff) plastered it all around the school and told my mum without my permission.

Young people coming out, a lot of the time, do not get the support from school that they should, or from

their parents. By telling my mum it made things worse and we dont even talk now. I feel like I cant talk to

anyone.


A creative way to learn what matters

Take time to learn about how things appear to me

Free drawingYou will need: paints and plastic scrapers, paint brushes, scourers, paper and collage material.

Simply draw, scribble, doodle, collage or paint. Illustrate what is important to you, what you like/dislike;

what you enjoy doing; your friends/family/ pets etc. You could create a fantasy island.

Talk about what you have chosen to represent.


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SECTION 2

Putting Values into Practice

An unexamined (professional) life is not worth living(Socrates)

The above quote, (with my word in parentheses) indicates that it is important to examine and concern

ourselves with how we live our (professional/work) lives. Part of that analysis rests on understanding of:

What is important? What really matters? Why it matters? and Where do our values lie?Imagine you were given 1million yours to keep, but based on a single condition: You are not allowed to

spend it or rid yourself of it. You are not allowed to give it away, transfer it, swap it or the like. You must

keep it in a box. What is that 1million worth to you now?

This scenario is designed to illustrate the view that if we have something, we might call precious then we

must spend it. We either spend it (as with money) or we spendtime looking and enjoying it, as with a piece

of art. Whatever it is, we must use it somehow.

It is important for you to consider that you have precious things that are worthwhile for the children and

young people for whom you work. That precious thing is YOU! Your personality, your knowledge and your

skills.

How often do you spend reviewing and checking how well you are spending such a valuable resource?

Do you spend these skills rashly, giving little attention to the benefit you (or other people) are accruing?

Do you ignore the issue? On the other hand you may spend time carefully assessing the impact of your

work to ensure you are getting the maximum return.

The Role of Evidence Based Practice and Values Based Practice

There is no doubt that facts (based on evidence) play a major role in our personal an d professional lives.

This section is intended to demonstrate the inter-relationship between evidence/facts and values and how

this relationship can be purposefully used.

The evidence base is central to the development of better services for young people. It is important that

young people have access to the best services staffed with the best people who are able to offer the best

known responses. However taking evidence alone is not sufficient and this explains the important link to

values.

Figure 1 presents an illustration of the link between values and evidence based/policy based practice. The

roles we perform are the visible elements of a structure such as a house. Whenever we can, we seek to

ensure the structure is made of the best materials (the best evidence or best policy). However, a solid

structure relies on firm foundations (the values which hold the structure in place). It is difficult to have a

strong structure without strong foundations.

The purpose of values based practice is to excavate the foundations to ensure they remain intact and able

to support the structure. To stretch the analogy further, foundations may have been laid many years ago,

when services were different and when the needs of children and young people were different.


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In the intervening years, the ground will have shifted and be assured it will shift again in the future.

Therefore maintaining our foundations requires regular attention.

Figure 1 Values provide the foundation for practice

Figure 2 provides an illustration of the relationship between the evidence base, the values base and

knowledge and skills required to perform and deliver satisfactory care to children and young people. It

reinforces the role that evidence does not exist in a vacuum; that values are an essential part of the

presentation and utilisation of facts/evidence. It is useful to refer back to the house analogy in Figure 1 to

examine the interplay between values, evidence and practice skills.

Figure 2 Research and values underpin skills

Evidence or policy

based practice attends

to the delivery of

practice

Essential capabilities

attends to the

foundations of practice

A structure with foundations which are not checked or scrutinised to

ensure they are still sound risks falling into disrepair and being a

structure of poor quality


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Values in the Context of Policy and Practice

A number of important policy and legislative actions in the care, treatment and support of children and

young people are rooted in core values. Sadly, these principles rarely get the attention they deserve, as at

their heart they pose significant challenges to all partners in the care treatment and support of children and

young people. This section invites you to review some of these important policy and legislative

requirements.

What is policy?

Usually, policy is defined as a statement of organisational expectations, which applies at national, regional

and local levels. Policy is designed to:

describe the objectives to be achieved identify the methods by which objectives are to be met identify behaviours and roles required to achieve policy aimsAt a national level, policy statements may be viewed as the objectives that organisations are expected to

deliver (and often associated with a companion audit programme to ensure fidelity to the policy

programme).

Ideally policy is a balancing act between the needs of people who use services, employers, employees,

funding bodies and other interested parties. Consequently good well balanced policy presents challenges

as competing views may be polarised from each other.

Exercise 11

Identify a piece of policy which directly relates to your work. Examine the key concepts or statements and

discuss with colleagues the inherent values based implications. What does the policy aim to achieve; is ituniversally believed that this is the right thing to achieve? What are the implications for the workforce in

delivery of the policy or legislation?


Making Policy Work

Given the above, policy statements and even formal legislation, are at the whim of human interpretation

and willingness to perform actions which support policy achievement. This situation means that people in

the workforce are fundamental to policy delivery. You, as a worker, are in the principal position to make

policy work.


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Logically, the emotional attachment you have to policy initiatives has a significant impact on if and how, the

aims of policy are achieved.

It is proposed in these learning resources that values play an important role in how workers attend to the

needs of employers and people who use services. This is equally true in a consideration of policy.

Exercise 12Listed below are some statements from key policy, guidance and legislation. See if you can work out which

policy the statement derives from and which EC particularly underpins it. Fill in as many spaces as you can.

Statement Policy/Guidance/Act Most relevant EC

It shall be the general duty of every local authority

(a) to safeguard and promote the welfare of children

within their area who are in need; and.

(b) so far as is consistent with that duty, to promote the

upbringing of such children by their families, byproviding a range and level of services appropriate to

those childrens needs.

States Parties shall assure to the child who is capable of

forming his or her own views the right to express those

views freely in all matters affecting the child, the views

of the child being given due weight in accordance with

the age and maturity of the child.

No single agency can deliver any one of the five

outcomes on its own.

There is more to do to improve the experiences and

engagement of fathers in particular, as well as parents

and children from more disadvantaged backgrounds.

Inform, involve and help the child or young person to

express what they are feeling. Help them to describe

what they are experiencing and to assess different

courses of action. Help them understand the

consequences of each and, where appropriate, agree

next steps.


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The answers are provided below; those in the second column are correct, whereas those in the third

column are suggestions you may have had different ideas. It demonstrates that the EC are inter-related.

Statement Policy/Guidance/Act Most relevant EC

It shall be the general duty of every local authority

(a) to safeguard and promote the welfare of children

within their area who are in need; and.

(b) so far as is consistent with that duty, to promote the

upbringing of such children by their families, by

providing a range and level of services appropriate to

those childrens needs.

Children Act 1989 Keep me safe, helping

me grow

States Parties shall assure to the child who is capable of

forming his or her own views the right to express those

views freely in all matters affecting the child, the views

of the child being given due weight in accordance withthe age and maturity of the child.

United Nations

Convention on the

Rights of the Child

1989

Listen and hear me

No single agency can deliver any one of the five

outcomes on its own.

Every Child Matters

2004

Communicate

together

There is more to do to improve the experiences and

engagement of fathers in particular, as well as parents

and children from more disadvantaged backgrounds.

Healthy lives,

brighter futures

2009

Respect our

differences

Inform, involve and help the child or young person to

express what they are feeling. Help them to describe

what they are experiencing and to assess different

courses of action. Help them understand the

consequences of each and, where appropriate, agree

next steps.

The children and

young peoples

workforce common

core of skills and

knowledge 2010

Be hopeful

Reviewing the Essential Capabilities

The purpose of this section is to begin the process of integrating all that you have learned and reflected on

this far. The 10 ECs for children and young people do not operate in isolation. The values you hold and the

values of others can rub up against each other and sometimes be in conflict with each other. In every case,

decisions still have to be made and actions taken. This section illustrates this complexity and to help draw

out routes to effective and collaborative decision making using the common core (knowledge and skills);the evidence base and values.

Section 1 provided you with an analysis of the 10 Essential Capabilities. In many respects these are values

and behaviours that you already subscribe to and try to implement in your practice. How often do you

attend to these foundations? How often do you examine your value base and that of others in helping you

maintain high quality practice and aspire to continuous improvement in your service delivery? This is the

essence of values based reflections on practice.

Section 2 has provided a brief overview of the role of values based practice in policy and legislative

requirements to support children, young people and their families.


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Follow these standards and you will make a great worker, like these examples

My psychiatric worker was fantastic. She had a really good way of speaking to people especially me. She

would listen to me and ask what I would like to do. She would take me out for a coffee and listen to me and

what I had to say. Sometimes I didnt want to talk to my family about things but I wanted to talk to her. She

had a really positive manner and had really good ways to solve things. We became very close and I trusted

her like a friend and I would never forget how she has helped me.When I first started seeing her for my depression she would try to tell me to take my medication but I would

always tell her that I am well enough and I dont need it. When she explained to me that it is best that I take

it, I listened to her and I improved. She introduced me to young people groups and activities for me to do

and she would take me to them to take my mind off things. She is brilliant and I hope everyone gets a

CAMHS worker like her. Thank you for everything.

Exercise 13

So how do you measure up?

Award yourself a score out of 10 (10 being the best and without fault) and identify the areas where you

would like to make some improvements

0 -101 Spot on with time keeping

2 No lame excuses for mistakes

3 Not a Mr/Mrs know it all

4 Well dressed but not too formal

5 Flexible

6 Positive attitude all of the time

7 Does not panic over anything

8 Empathetic worker not sympathetic.

9 Good attendance and not having many sick days.

10 Supportive and helps me out

11 Kind, good, friendly, helpful, nice manners, friendly face, good personality

12 Listens to us, tries to understand and helps you in the best way possible.

13 Someone who makes me laugh.

14 Gives us information - explains what the service is, why we are there, how they can help us.

15 Takes time to introduce the service properly to us so that we feel comfortable.

16 Is polite and tells us their name and a bit about them

17 Shows us respect and answers all our questions when asked

18 Someone who isnt always right and argumentative and doesnt criticise your personality.

19 A good people person

20 Nice people who know what they are talking about knowledgeable

21 A person who takes time to build a relationship with me and for me to trust you.

22 Does what they say they are going to do

23 Talks clearly, at the right times and not over us

Checklist for a great worker:


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References

Childrens Workforce Development Council (2010) The Common Core of Skills and Knowledge. CWDC. Leeds

Department for Education and Skills (2001) Building a Strategy for Children and Young People. Department for

Education and Skills. London

Department for Education and Skills (2003) Change for Children Programme, Every Child Matters (2003) Department

for Education and Skills. London

Department for Education and Skills (2005) Youth Matters Department for Education and Skills. London

Department of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) Department of Health London

Department of Health (2004) National Service Framework for Children, Young People and Maternity Services

Department of Health London.

Woodbridge, K. & Fulford, B. (2004) Whose Values? A Workbook for Values Based Practice in Mental Health Care.

Sainsbury Centre for Mental Health. London


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Appendix 1

The Ten Essential Shared Capabilities

A Brief History

The issue of core descriptions of quality care (for mental health) was developed by the National Institute

for Mental Health in England (NIMHE). They worked closely with people who used mental health services

as well as those involved in giving care (nurses, Doctors and others). They were asked to write down what

they thought the signs of good care were and these became the 10 Essential Shared Capabilities (ESC) in

mental Health.

The ESC have been used in mental health services for some years to help workers in mental health

understand what patients/Clients/Service Users want from them.

The ESC are important because both service users and carers strongly believe they describe the parts of a

supportive relationship built on mutual trust and respect. The ESCs are a set of values with associated

behaviours that mental health practitioners should hold and display in all meetings and conversations.

These values can and should underpin not only conversations with service users and carers, but alsodiscussions with colleagues in mental health and other services.

The ESC encourages care providers to review how they do their job and to think about ways in which they

could improve their work to best meet the needs of Children and Young people.

1. Working in Partnership. Developing and maintaining constructive working relationships with service users,

carers, families, colleagues, lay people and wider community networks. Working positively with any

tensions created by conflicts of interest or aspiration that may arise between the partners in care.

2. Respecting Diversity. Working in partnership with service users, carers, families and colleagues to provide

care and interventions that not only make a positive difference but also do so in ways that respect and

value diversity including age, race, culture, disability, gender, spirituality and sexuality.

3. Practising Ethically. Recognising the rights and aspirations of service users and their families,

acknowledging power differentials and minimising them whenever possible. Providing treatment and carethat is accountable to service users and carers within the boundaries prescribed by national (professional),

legal and local codes of ethical practice.

4. Challenging Inequality. Addressing the causes and consequences of stigma, discrimination, social inequality

and exclusion on service users, carers and mental health services. Creating, developing or maintaining

valued social roles for people in the communities they come from.

5. Promoting Recovery. Working in partnership to provide care and treatment that enables service users and

carers to tackle mental health problems with hope and optimism and to work towards a valued lifestyle

within and beyond the limits of any mental health problem.

6. Identifying Peoples Needs and Strengths. Working in partnership to gather information to agree health

and social care needs in the context of the preferred lifestyle and aspirations of service users their families,

carers and friends.

7. Providing Service User Centred Care. Negotiating achievable and meaningful goals; primarily from the

perspective of service users and their families. Influencing and seeking the means to achieve these goals

and clarifying the responsibilities of the people who will provide any help that is needed, including

systematically evaluating outcomes and achievements.

8. Making a Difference. Facilitating access to and delivering the best quality, evidence-based, values-based

health and social care interventions to meet the needs and aspirations of service users and their families

and carers.

9. Promoting Safety and Positive Risk Taking. Empowering the person to decide the level of risk they are

prepared to take with their health and safety. This includes working with the tension between promoting

safety and positive risk taking, including assessing and dealing with possible risks for service users, carers,

family members, and the wider public.

10. Personal Development and Learning.Keeping up-to-date with changes in practice and participating in life-long learning, personal and professional development for ones self and colleagues through supervision,

appraisal and reflective practice.


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Appendix 2

Mr. Peter Luff MP (Mid-Worcestershire):

I think that left-handedness is an issue of equal opportunity. The discrimination at one level may be less

than it was, but only this morning I heard on BBC Hereford and Worcester of a seven-year-old boy whose

school had tried to force him to write with his right hand. I do not think that it used the more aggressive

methods of our Victorian forebears--tying a hand behind the back or on to a chair--but it subtly encouraged

him to use his right hand. He could not do it. It was only when he had a new teacher, who understood the

problems of left-handedness and helped him to cope with them, that his academic work progressed as it

should have done. He was absolutely delighted with what happened after the new teacher took control of

his destiny.

The problem is that children who are encouraged to believe that there is something wrong with writing

left-handed ask, "Why is what is right for me wrong?" They cannot understand it. In class, that manifests

itself in all sorts of ways. Children who have difficulty with their writing, their colouring or their cutting out,

because they have been encouraged to regard themselves as right-handed, will try to avoid the activities

that cause them difficulty, leading directly to slow development and under-achievement.

Teachers need to be trained to recognise the symptoms of left-handedness, respond to them positively and

help those children to use their left hands. Left-handed children who try to use their right hand will often

cope, but that is all they will do. They will not excel as they might have done, and their development is

delayed. Only if teachers are encouraged to recognise left-handedness early will that be prevented.

Hansard House of Commons debate: 22 Jul 1998


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Appendix 3 Mandala

For more go to http://www.free-mandala.com/en/start.html
http://www.free-mandala.com/en/start.htmlhttp://www.free-mandala.com/en/start.html


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Appendix 4

National CAMHS Support Service (NCSS)

National Workforce Programme

Individual Audit of

The Essential Capabilities for Effective

Emotional and Mental Health Support

Completing your questionnaire

It will take about 30 minutes. The information in the completed questionnaire will be used as part of your

training programme for the Essential Capabilities for Effective Emotional and Mental Health Support for

children and young people. The questions are designed to help you reflect on how you approach your

practice and how this coincides or sometimes collides with the practice of others in your team.

IMPORTANT: This is not about proving who is right and who is wrong! The questions and your reflections

are purely aimed at respecting other peoples perspectives on what providing effective emotional and

mental health support means to them. The purpose of the exercise is to begin to debate how a consistent

approach to care, treatment and support for young people can evolve, even within the context ofdifferent world views in a team.

Please complete each question. Tick boxes where appropriate.

Name:

Team Name:

InstructionsThis scale is designed to help you assess the practice of your team as a whole and also your own personal

practice in relation to core values as identified in the Essential Capabilities for Effective Emotional and

Mental Health Support. On each question, it is important to make a general and honest assessment on

each of the scales.

To answer the questionnaire, you will note the question stem is in the centre of the scale. Either side is a

scale for your assessment of the team views and behaviour (Scale T) and a scale for your own personal

views and behaviour (Scale P). It is important to make a mark ( ) in each of the scales for each of the

questions/statements.

There are no right or wrong answers, so please answer as honestly as you can.


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important in the work here

Documents

CAMHS Workbook